How do Fillings Work?

If cavities have been discovered during a dental examination, they will need to be immediately treated. This is especially important for cases where the cavity has damaged the tooth enamel and underlying dentin. If cavities are in their early stages and have not affected the dentin, they can be healed or re-mineralized with fluoride.

The goal of cavity treatment involves two basic concepts: removing the decayed portion of the tooth, and restoring missing tooth structure using fillings.  The procedure begins with an injection of a local anesthetic, which is xylocaine for most cases.  The tooth will be isolated from the rest of the mouth and be drilled to remove the decay and prepare it for the filling.

Depending on the type of material used, the preparation procedure will be adjusted accordingly. Commonly used liners include gluma, copalite varnish, and dycal. Dycal is a compound that contains calcium hydroxide and is used to stimulate dentin for dental pulp regeneration. Deeper fillings require a base to supplement the liner.

Common bases under dental fillings are glass ionomer cement and zinc phosphate cement. The purpose of the base is to insulate the tooth and protect it from temperature changes in the mouth.  Both the dentist and patient can choose various materials to be used as the tooth filling. Common ones include silver (amalgam), white (resin), porcelain, or gold fillings.

After the filling of the tooth, it is not unusual to experience sensitivity for a couple of days. Deeper fillings may have longer periods of increased sensitivity. Sensitivity lasting for two more weeks may indicate a void underneath the filling. Root canal therapy may be required if continued discomfort is experienced.

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